Cevimeline Hcl (cevimeline HCl)

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Last reviewed · Source: First Databank (FDB) drug data

Overview

Cevimeline hydrochloride is a cholinergic agonist that binds to muscarinic receptors.

Cevimeline hydrochloride, a quinuclidine derivative of acetylcholine, is a cholinergic agonist that binds to muscarinic receptors. In sufficient dosages, muscarinic agonists can increase exocrine (e.g., salivary, sweat) gland secretion and increase GI and urinary tract smooth muscle tone.

Cevimeline is pharmacologically similar to pilocarpine, another oral cholinergic agonist that exerts predominantly muscarinic action. Both drugs stimulate residual salivary gland tissues and have been shown to substantially increase salivary flow. However, the adverse effect profile of the drugs may differ based on differences in selectivity and affinity for specific muscarinic receptor subtypes.

Cevimeline is a more selective muscarinic agonist than pilocarpine and exhibits a 40-fold greater affinity for M3 muscarinic receptors in the lacrimal and salivary glands than for M2 receptors in cardiac tissue.

Cevimeline is rapidly absorbed following oral administration; peak plasma concentrations are reached in approximately 1.5-2 hours. Cevimeline is metabolized by cytochrome P-450 (CYP) isoenzymes 2D6, 3A3, and 3A4. In an in vitro study, CYP isoenzymes 1A2, 2A6, 2C9, 2C19, 2D6, 2E1, and 3A4 were not inhibited by cevimeline.

The drug is excreted principally in urine, with 97 and 0.5% of a 30-mg dose recovered in urine and feces, respectively, after 7 days.

USES: This medication is used to treat symptoms of dry mouth due to a certain immune disease (Sjogren's syndrome). Cevimeline belongs to a class of drugs known as cholinergic agonists. It works by stimulating certain nerves to increase the amount of saliva you produce, making it easier and more comfortable to speak and swallow.

Generic name: cevimeline HCl
Pronunciation: (seh-VIMM-eh-leen)

Reference product & biosimilars

No reference, biosimilar or interchangeable associated with this drug.

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Indications

The following indications are listed for Cevimeline Hcl:

  • Xerostomia Secondary To Sjogren's Syndrome

Also known as: Xerostomia Secondary To Gougerot-Sjogren Disease, Xerostomia Secondary To Sicca Syndrome, Xerostomia Secondary To Sjogren's Disease.

Dosing

Dosage of cevimeline hydrochloride is expressed in terms of cevimeline.

The recommended adult dosage of cevimeline for treatment of dry mouth secondary to Sjogren syndrome is 30 mg 3 times daily. Safety and efficacy of dosages exceeding 90 mg daily have not been established.

Drug interactions

There is no enhanced messaging for this drug.

Contraindications

Known hypersensitivity to cevimeline hydrochloride, uncontrolled asthma, and when miosis is undesirable (e.g., acute iritis, angle-closure glaucoma).

Adverse reactions

Adverse effects occurring in 3% or more of patients receiving cevimeline include excessive sweating, headache, nausea, sinusitis, upper respiratory tract infection, rhinitis, diarrhea, dyspepsia, abdominal pain, urinary tract infection, cough, pharyngitis, vomiting, injury, back pain, rash, conjunctivitis, dizziness, bronchitis, arthralgia, surgical intervention, fatigue, and pain.

Precautions

No enhanced messaging available.

ICD codes

No ICD codes are available for this drug.

Formulary status

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Last reviewed · Source: First Databank (FDB) drug data